GUIDE 2025 – COMPREHENSIVE DRUG REVIEW WITH
PRACTICE QUESTIONS AND ANSWERS
Metformin
first drug of choice with new Type 2 Diabetes; inhibits glucose in liver, slightly reduces
glycose absorption in gut, increases glucose uptake; DOES NOT drive insulin down, very
low risk for hypoglycemia
TSH levels
normal range is 0.4 to 4.0 mu/L. If you are being treated for a thyroid disorder, the normal
range is 0.5 to 3.0 mu/L. A value above the normal range indicates that the thyroid is
underactive. This indicates hypothyroidism.
Hypothyroidism Presentation
inadequate amounts of hormone; slows body function and processes, cold, pale puffy
face, skin cool and dry, low HR, low temp, lethargy, fatigue
Hypothyroidism in pregnancy
must treat to avoid neuro issues in child
Hypothyroidism in newborns
require replacement within a few days, lasts for 3 years, prevents mental development
changes and growth patters, dwarfish
,How do you take Levothyroxine (t4)
on an empty stomach for increased absorption
Hashimoto disease presentation
weight gain and fatigue; autoimmune disease
Hyperthyroidism (thyrotoxicosis) presentation
elevations in T4 and T3, tachyarrhythmias, anxiety, insomnia, rapid speech, hot
Graves Disease
women 20-40 most susceptible, remove or destroy thyroid tissue or suppress with drugs
(methimazole or propylthiouracil), treat with Iodine - I31, beta blockers also used to
suppress release of thyroid hormones
Plummer disease (toxic nodular goiter)
result of thyroid adenoma (tumor), same as Graves disease, but absence of exophthalmos
(bulging eyes)
Thyroid storm
, caused by major surgery or severe illness such as sepsis, 105 F, severe tachycardia,
restlessness, tremor, heart failure, coma. Treat with Propylthiouracil (PTU), symptom
management
Histamine - 1 antihistamines
cause vasodilation, bronchoconstriction, help with memory and sleep. Relieve itching,
pain, secretion, and mucus (allergies). Side effects: sedative, dry mouth, urinary
hesitancy,, constipation. Second generation (-ine) are non-sedating
Histamine 2 Receptor Antagonists
secretion of gastric acid; treat gastric and duodenal ulcers
Stage I HTN
130-139/80-89
Stage 2 HTN
>140/90
Med used after heart attack
Beta blocker - use for 6 months